Background: Severe obesity is a multisystemic chronic disease associated with significant neurocognitive impairments, including deficits in executive functions, memory, and attention. Traditional weight loss interventions often overlook these neurological and psychosocial barriers. Systemic Neuro-Integral Rehabilitation, combining cognitive training, functional neurorehabilitation, and Cognitive-Behavioral Therapy (CBT), emerges as a holistic approach to bridge this gap. This protocol outlines a systematic review to evaluate the efficacy of these multidisciplinary interventions in women with severe obesity. Methods: This review will follow the PRISMA guidelines and is registered in PROSPERO (CRD420261356828). A systematic search will be conducted in MEDLINE (via PubMed), Scopus, and Web of Science for Randomized Controlled Trials (RCTs) involving women with severe obesity (BMI 40 kg/m² or 35 kg/m² with comorbidities). Interventions of interest include cognitive and functional neurorehabilitation compared to conventional exercise or nutritional education. Two independent reviewers will perform study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Data will be synthesized through a narrative approach and, if feasible, a meta-analysis using random-effects models. Results: The review aims to demonstrate that integrated neurofunctional interventions lead to superior improvements in executive functions, working memory, and functional capacity compared to isolated treatments. Additionally, improvements in mental health (anxiety, depression, and body image) and autonomic regulation (heart rate variability) are anticipated. Conclusion: By synthesizing evidence on neurocentric approaches, this review seeks to provide a foundation for new clinical guidelines that prioritize cognitive health as a pillar for long-term therapeutic success and autonomy in women with severe obesity.
Background: Parkinson's disease (PD) is a progressive neurodegenerative condition that predominantly affects older individuals , with significant impacts on quality of life. It is characterized by motor symptoms, such as tremors and bradykinesia, and non-motor symptoms, such as sleep disorders. Given the complexity of PD, it is essential to deepen the analysis of the factors that interfere with quality of life, contributing to the development of integrated therapeutic strategies. Objective: To evaluate the relationship between PD progression and sleep quality and performance in activities of daily living. Methods: This is a cross-sectional observational study, conducted at the State University of Minas Gerais, involving individuals with a clinical diagnosis of PD. Participants will be recruited through a search in the Electronic Citizen Record system, in Public Health Centers of Primary Health Care in the city of Divinópolis - MG. To assess PD progression, the following tests will be conducted: the Modified Hoehn and Yahr Scale and parts I, II, and III of the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS). Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Parkinson's Disease Sleep Scale (PDSS) and functionality will be assessed using the Five-Repetition Sit-to-Stand Test and the Coin Rotation Test. Discussion: The increased prevalence of PD and gaps in the literature on sleep quality and impact on ADLs may aggravate functional impairments and quality of life of these patients.
Background: Aging leads to a reduction in strength, changes in gait, and compromised balance, increasing the risk of falls and constituting a serious public health problem. Tai Chi Chuan (TCC) has proven effective in preventing these events in the elderly. Objective: Analyze the effectiveness of adapted forms of TCC as a method for fall prevention in the elderly. Methods: This is a systematic review of the literature. The databases PubMed, SciELO, LILACS, and Google Scholar were consulted. Randomized clinical trials (RCTs) published in English between January 1, 2015, and February 18, 2025, involving elderly individuals aged ≥60 who underwent adapted TCC interventions, compared to active or inactive controls, were included. Studies outside the topic, with insufficient methodological description, that were not RCTs, that recruited elderly individuals with prior experience in TCC, or with cognitive, neurological, or functional impairments, as well as special populations, were excluded. The studies were selected by two independent reviewers. The characteristics of the studies eligible to be included in this review were extracted and tabulated, likewise by two independent reviewers. The synthesis of the results was conducted thru narrative synthesis. The methodological characteristics and the effects of the interventions were analyzed and compared qualitatively. Results: Seven studies were included, totaling 1,017 elderly individuals. All the studies used adapted forms of TCC and demonstrated positive effects on factors related to fall risk. Only one RCT directly assessed the incidence of falls, recording a significant reduction after the TCC intervention. Conclusion: Adapted forms of TCC are effective in preventing falls in the elderly. However, overly simplified protocols or those with a frequency of more than four sessions per week reduce adherence and compromise the results. Future studies should adopt the incidence of falls as the primary outcome and rigorously monitor adherence and dropout.
Background: Total knee arthroplasty (TKA) is a widely used procedure to treat advanced osteoarthritis, providing pain relief and functional improvement. However, the long-term success of the surgery depends on the precision in the positioning of the prosthetic components and the proper alignment of the operated limb. Objective: Describe the case of a 52-year-old patient, diagnosed with advanced gonarthrosis, who underwent TKA with the aid of augmented reality (AR). The patient had a history of hypertension, grade I obesity, and complaints of chronic pain in the right knee, with functional limitation and claudication. Method: The procedure was performed using prosthetic implants from the brand MicroPort Advanced®, with a navigation system assisted by AR, aiming for greater precision in correcting the mechanical axis and better adaptation of the components. Results: The surgery proceeded without complications, with a satisfactory postoperative evolution, including rapid functional recovery and significant symptom relief. Conclusion: The use of AR can offer significant advantages in surgical precision and functional outcomes, representing a promising alternative to optimize the longevity of implants in environments with limited infrastructure.
Background: Low back pain (LBP) has emerged as a significant public health issue among adolescents, with lifetime prevalence reaching 40%. Sedentary behaviors, such as excessive screen time, are linked to increased risk, while the school environment offers a strategic setting for early intervention. This systematic review aims to identify the most effective school-based exercise interventions for reducing non-specific LBP in this population. Methods: Developed according to PRISMA-P guidelines and registered in PROSPERO (CRD420261297319), this review focuses on non-randomized studies involving adolescents aged 10–19 with non-specific LBP. Primary outcomes include pain intensity measured by validated scales like the Visual Analogue Scale. Electronic searches will be conducted in MEDLINE, PubMed, Scopus, and CENTRAL. Selection, data extraction, and risk of bias assessment (using the ROBINS-I tool) will be performed independently by two reviewers. Results: A narrative synthesis will be performed, with potential meta-analysis using a random-effects model if methodological homogeneity is met. Conclusion: By synthesizing "real-world" interventions, this review will provide evidence-based guidelines for healthcare and education professionals. Addressing LBP in adolescence serves as a crucial preventive strategy against chronic disability in adulthood.
Background: Hemodialysis is a component of renal replacement therapy used for patients with end-stage chronic kidney disease. Nevertheless, its impact on physical function, as assessed by the 6-minute walk test, remains uncertain. Objective: This crossover and randomized study aimed to evaluate the acute effects of hemodialysis on 6-minute walk test performance. Methods: Ten participants, half of whom were male, were enrolled. Participants were sourced from the hemodialysis unit of a renal institute, aged 18 or older, who had undergone hemodialysis for at least 1 month. Data on demographics and blood parameters were collected. The 6-minute walk test was conducted either before or after hemodialysis sessions, with walk distance and heart rate recorded. The cardiac efficiency index was calculated as the ratio of walking distance to heart rate. Results: Although no significant differences in heart rate were observed between pre- and post-hemodialysis sessions, a notable increase in walking distance was observed post-hemodialysis (19.4 ± 25.6 meters, p < 0.05). Conclusions: Our findings suggest that acute hemodialysis can effectively enhance walking distance and cardiac efficiency during the 6-minute walk test in patients with end-stage kidney disease.
Background: Anxiety are among the most common mental disorders across different populations. Objective: This study aimed to evaluate the effects of a single Pilates session on anxiety symptoms in two different practice environments. Method: The sample included 26 individuals, divided into two groups: Outdoor Pilates (OP, n = 9) and Studio Pilates (SP, n = 17). Each session lasted approximately 50 minutes and comprised a warm-up, followed by mobility and muscle-strengthening exercises using dynamic and static movements targeting the upper and lower limbs as well as the trunk. Anxiety "state" was assessed using the State-Trait Anxiety Inventory (STAI-S). Results: Mean anxiety scores decreased in both the OP group (∆% = –33.1, d = 1.41) and the SP group (∆% = –17, d = 0.72). A positive correlation was observed between recent distress and pre-session anxiety levels (Pearson’s r = 0.70, R² = 0.489), while a negative correlation was found between habitual physical activity and anxiety (Pearson’s r = –0.543, R² = 0.294), both statistically significant at p < 0.01. Conclusion: A single Pilates session, whether conducted outdoors or in a studio, positively impacts anxiety levels in adults. However, the reduction in anxiety was more pronounced in the outdoor environment, suggesting greater effectiveness in natural settings.
Background: School closures during the COVID-19 pandemic increased children’s exposure to obesogenic behaviors, potentially affecting weight status. Objective: To report temporal trends in the weight status of children aged 6 to 9 years before, during, and after school closures in response to restrictions imposed by the COVID-19 pandemic, using a three-year school-based cohort design. Method: Weight status was analyzed using the body mass index and diagnostic criteria proposed by IOFT. Initial data collection took place in 2020 (pre-pandemic period), in 2021 and 2022 (pandemic period), and in 2023 (post-pandemic period), after the reopening of schools. Results: The data collected confirmed that restrictions imposed to mitigate the adverse impact of the COVID-19 pandemic, including the full or partial closure of schools, substantially increased children's weight above what would be expected for their sex and age. After two years of the pandemic period, 16% of children identified in the pre-pandemic period as with normal weight migrated to overweight, while 23% with overweight became obese. Data collected during the post-pandemic period showed signs of a reduction in excess weight accumulated during the pandemic; however, the prevalence rates of overweight and obesity remained at 14% and 26%, respectively, which were higher than in the pre-pandemic period. Conclusion: The findings suggest that the harmful effects contributing to greater weight gain during the COVID-19 pandemic were not spontaneously reversed. Therefore, specific actions to combat overweight and obesity are essential to avoid present and future adverse consequences in children's health.
Background: Severe obesity is a chronic and multifactorial condition associated with significant physical and psychological impacts, including high rates of depression and anxiety. Bariatric surgery is recognized as the most effective treatment for cases of severe obesity, promoting sustained weight loss, improvement of comorbidities, and enhancement of quality of life. However, the trajectory of psychological symptoms after the procedure is still uncertain, especially among patients who already experienced emotional distress before the surgery. Objective: This systematic review and meta-analysis protocol aims to synthesize evidence on the changes in depression and anxiety levels in adults with severe obesity and pre-existing symptoms undergoing bariatric surgery. Methods: Longitudinal cohort studies, either prospective or retrospective, that assess symptoms of depression and anxiety before and after surgery, using validated psychometric instruments such as the Beck Depression Inventory, Hospital Anxiety and Depression Scale, Beck Anxiety Inventory, and Generalized Anxiety Disorder-7, will be included. The search will be conducted in the PubMed, Web of Science, and Scopus databases, without language restrictions, starting from June 26, 2025. The methodological quality will be assessed using the Newcastle-Ottawa Scale, and the quantitative synthesis will be conducted thru a random-effects meta-analysis when there is homogeneity among the studies. Conclusion: It is expected that this review will provide consistent evidence on the evolution of depressive and anxious symptoms after bariatric surgery, contributing to the improvement of psychological follow-up strategies and strengthening the comprehensive care of patients with severe obesity.
Background: The education of students with Giftedness/High Abilities (G/HA) and Twice Exceptionality (2e) represents a challenge in the Brazilian context, especially due to the phenomenon of motor asynchrony. This condition, characterized by a mismatch between advanced cognitive development and fine and gross motor skills, manifests as graphomotor difficulties, poor coordination, and low body confidence. Despite the legal framework guaranteeing educational rights for this population, there is a significant gap between legislation and effective identification and intervention practices in the school environment. Objectives: This scoping review aimed to map and analyze the scientific literature on motor asynchrony in students with G/HA and 2e, as well as to identify psychomotor, pedagogical, and socio-emotional intervention strategies applied in school settings between 2008 and 2025. Methods: The research followed the PRISMA-ScR protocol, covering thirteen national and international databases (PubMed, LILACS, ERIC, Scopus, Web of Science, SciELO, among others). The search yielded 192 initial records, of which 16 articles met the inclusion criteria after screening. Data analysis was based on thematic categorization, yielding three main themes: identification of motor asynchrony, student characteristics, and intervention strategies. Conclusions: The analysis revealed that motor asynchrony is an intrinsic manifestation of the development of students with G/HA and 2e, impacting their academic expression, self-image, and engagement. The most effective interventions were holistic and interdisciplinary, integrating psychomotricity, inclusive physical education, occupational therapy, differentiated teaching strategies, and emotional support. The study proposes an Inclusive Educational Model for Body-Cognition Integration (MEICC) with seven interconnected components, aiming to overcome the mind-body fragmentation and promote the holistic development of these students. It is concluded that integrating the body as a dimension of intelligence is essential to reduce underachievement and broaden the participation and well-being of these students in the school environment.
Background: Physically independent older adults are considered active in daily life activities. However, as age progresses, physiological changes increase the risk of falls. Thus, any obstacle requiring attention, balance, and/or reaction may result in a fall. Objective: To present the prevalence of falls among older adults 12 months after the assessment of overall strength and functional reach during the pandemic. Methods: This is a longitudinal and observational study involving 69 older adults of both sexes (age: 69 ± 7 years; body mass index: 27 ± 4 kg/m²). Participants answered a structured interview with questions about the occurrence of falls after 12 months. Additionally, data from handgrip strength and functional reach assessments contributed to understanding participants’ functionality. Results: The majority of the studied population consisted of women (88%). Over the 12-month period, 80% of participants did not experience falls. Among those who fell, the main consequences were fractures (8%) and ankle sprains (8%), occurring predominantly in women. The most frequently reported fall locations were sidewalks (36%), homes (29%), streets (21%), and yards (14%). Tripping was the primary cause of falls, reported by 57% of participants. Finally, reduced handgrip strength was observed in 9% of men and 16% of women, while reduced functional reach was identified in 1% of men and 24% of women. Conclusion: The findings of this study indicate that the incidence of falls among older adults evaluated after 12 months was 20%, with no major consequences such as hospitalization or disabling injuries. Additionally, falls occurred predominantly in women and in public environments, especially on sidewalks.
Background: Myofascial trigger points are considered one of the main myofascial pain syndromes in the neck, characterized by regional pain and muscle tenderness with the presence of hypersensitive nodules in the muscle band. Several techniques are tested for controlling this pain, one of the options being joint manipulation. These techniques can be used either individually or even combined, in order to elicit neurophysiological responses related to pain processing and inhibition. Objectives: Evaluate the immediate effects of combined joint manipulation versus isolated application of this technique on the pressure pain threshold in individuals with trigger points in the upper trapezius fibers. Methods: Thirty participants aged between 18 and 30 years with myofascial trigger points in the upper trapezius muscle were distributed into three groups: cervical manipulation, thoracic manipulation, and combined manipulation. The visual analog scale and pain threshold were measured pre- and post-intervention in the upper trapezius muscle. Results: The results showed a significant difference between groups for pain (p=0.009), but there was no difference between groups for pressure pain threshold. Other studies have already shown significant effects of joint manipulation on pain and pressure pain threshold in individuals with myofascial pain. The combination of interventions that have neurophysiological responses related to pain inhibition has superior effects compared to local response techniques. Conclusion: It was concluded that cervical joint manipulation combined with thoracic manipulation was more effective in reducing myofascial trigger point pain in the trapezius muscle than cervical or thoracic manipulation applied in isolation. There was no difference in relation to the pressure pain threshold.
Introdução: O salto com contramovimento (CMJ) é amplamente utilizado para avaliar o desempenho neuromuscular em diversos contextos. Para fins de avaliação, aplicativos como My Jump Lab e JumPo 2 surgem como alternativas acessíveis às plataformas de força, oferecendo praticidade e baixo custo. No entanto, até o momento, nenhum estudo investigou diretamente a concordância entre esses dois aplicativos na mensuração de variáveis do CMJ. Objetivo: Verificar a concordância das variáveis derivadas do CMJ entre os aplicativos My Jump Lab e JumPo 2. Métodos: Cinquenta mulheres adultas jovens realizaram três CMJ máximos enquanto eram filmadas simultaneamente com a câmera de um smartphone. Cada salto foi analisado utilizando os aplicativos My Jump Lab e JumPo 2, considerando os seguintes parâmetros: altura do salto (cm), tempo de voo (ms), força (N) e potência (W). Para comparar os aplicativos, foram utilizados o teste t, correlação de Pearson, coeficiente de correlação intraclasse (CCI), gráficos de Bland-Altman e tamanhos de efeito (d de Cohen), com nível de significância de p < 0,05. Resultados: A diferença entre as aplicações foi baixa (p > 0,05), com tamanhos de efeito insignificantes (d < 0,20), além de apresentar alta correlação para todos os parâmetros observados (altura do salto: Δ = 0,19 ± 1,04 cm, d = 0,17, ICC = 0,985, r = 0,973; tempo de voo: Δ = 0,52 ± 12,97 ms, d = 0,04, ICC = 0,983, r = 0,967; força: Δ = 23,16 ± 150,72 N, d = 0,15, ICC = 0,825, r = 0,705; potência: Δ = 21,55 ± 133,93 W, d = 0,16, ICC = 0,918, r = 0,850. Conclusão: Os aplicativos para smartphones My Jump Lab e JumPo 2 apresentam alta concordância na análise de medidas derivadas do CMJ, especialmente para altura do salto e tempo de voo.
Background: The growth of the older adult population requires special attention to their health, as chronic diseases can affect their functional capacity and quality of life. Falls are frequent in this group, but it is unclear whether the time elapsed since the fall influences muscle strength, agility, and postural control. Objective: To investigate differences in strength, functional performance, and postural control in physically independent older adults, divided into three groups based on the time since the fall: less than 6 months, 6 to 12 months, and more than 12 months. Method: A total of 137 participants were evaluated, analyzing fall characteristics, fear of falling, and medication use. Muscle strength was measured using the handgrip test, while agility was assessed with the AGILEQ test. Postural control was examined using a force platform, analyzing unipedal balance. Results: The results showed that the participants' average strength was 25 kgf, below the cutoff for men (27 kgf) and above for women (16 kgf), but with no clear association with the time since the fall. Tripping was the most common cause. Regarding agility, no significant differences were found between the groups, suggesting that independent older adults maintain strength and confidence in mobility. In postural control, previous studies indicate worse performance in older adults who have fallen, but our analysis found no variations between groups according to the time since the fall. Conclusion: In conclusion, no significant differences in functional performance were observed among the groups analyzed. Longitudinal studies are needed to better understand recovery and adaptation after falls, including factors such as physical activity levels. This may contribute to the development of more effective strategies for rehabilitation and fall prevention in older adults.
Introdução: A incidência de quedas na população idosa está ligada ao declínio de suas capacidades físicas e mentais. Esse acidente impacta negativamente a autonomia e a sobrevivência do idoso, além de representar um alto custo para o sistema de saúde. A prática de atividade física é descrita como essencial para um envelhecimento saudável, e o método Pilates se destaca pela sua popularidade entre esse público. Objetivos: Avaliar se o método Pilates pode estimular alterações sensório-motoras efetivas para reduzir o risco de quedas em idosos. Métodos: Nesta revisão sistemática, foram buscados ensaios clínicos publicados entre 2014 e 2024 na Biblioteca Virtual em Saúde (BVS), nos idiomas português e inglês. Os critérios de exclusão incluíram estudos envolvendo pessoas com menos de 60 anos, gestantes, portadores de síndromes, patologias neurológicas e/ou disfunções musculoesqueléticas e atletas, bem como publicações focadas em intervenções não relacionadas ao Pilates e aquelas que não avaliaram os possíveis desfechos escolhidos para esta revisão. Resultados: Após a aplicação dos critérios de elegibilidade, 8 de 257 publicações foram selecionadas para discussão. Os resultados obtidos são positivos e demonstram que o método Pilates é uma intervenção promissora para a redução do risco de quedas em idosos. Conclusão: Os estudos analisados apresentam limitações quanto ao número de participantes. Dessa forma, os resultados obtidos não são suficientes para representar o perfil populacional analisado. São necessárias novas pesquisas e estudos em larga escala, com amostra capaz de representar a população idosa em sua totalidade.
Background: Type 1 diabetes Mellitus (T1DM) is a chronic condition characterized by an absolute deficiency of insulin, requiring rigorous glycemic control to prevent acute and chronic complications. Evidence suggests that physical exercise can positively influence glycemic control, although its acute effects on blood pressure (BP) and glycemia in adults with T1DM are still poorly understood. Objective: To evaluate the effects of resistance training on glycemic control, muscle strength, and the incidence of hypoglycemic episodes in patients with T1DM. Methodology: This study will be conducted thru a systematic review of clinical trials and observational studies published between the years 2014 and 2024. Studies addressing the effects of resistance training in patients with T1DM will be included, focusing on parameters such as glycemic control, muscle strength, and comparisons with other types of exercise or sedentary groups. Data collection will be conducted by independent reviewers, who will extract and record relevant information about the resistance training protocols used, clinical outcomes, and possible adverse events, such as episodes of hypoglycemia. Conclusion: It is expected that the systematic review will provide consistent evidence on the benefits of resistance training as a complementary strategy in the management of T1DM. By better understanding its effects on glycemic control and muscle strength, as well as the associated risks, especially regarding hypoglycemia, it will be possible to more accurately guide the prescription of physical exercises for this population, contributing to an improvement in the quality of life and clinical prognosis of patients.
Background: The autonomic nervous system (ANS) can be modulated through various manual therapy techniques (MTT) on the cervical spine. However, it remains unclear whether these modulations have clinically relevant effects on the heart rate (HR) of individuals with craniocervical dysfunctions (CCD). Objective: This study aims to review existing research on MTT applied to the cervical spine and its effects on HR in patients with CCD. Methods: This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42019126739. No funding was received for this study. Articles were identified through searches in PubMed, Web of Science, CENTRAL and EMBASE. Eligible studies assessed HR before and after MTT. The risk of bias was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and the certainty of the evidence was determined using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Results: Three articles met the eligibility criteria. One study reported a significant increase in HR following the application of the high-velocity low-amplitude (HVLA) technique, while another indicated clinically significant increase in HR after mobilization techniques. Both studies demonstrated high methodological quality but were classified as having a very low level of evidence. Discussion: The findings suggest that MTT can stimulate the ANS, whether through HVLA or mobilization techniques, regardless of the specific cervical level targeted. However, the inconsistency of the data across studies complicates more precise analyses.
The XXV Brazilian Congress of Physiotherapy was an online conference held from October 1 to 3, 2024, with the theme "Physiotherapy and Technologies: Expanding Boundaries and Shaping the Future." The event brought together renowned professionals to discuss innovative clinical practices, offering a valuable educational experience for students and professionals in the fields of health, pedagogy, psychopedagogy, and social work. The participants received a certificate of XX hours, and the proceedings will be published in a recognized scientific journal.
Background: The increase in the number of university students using electronic smoking devices (ESDs) contributes to the advancement of unfavorable impacts in this population, including on sleep quality. Recognizing these changes is essential, as they can negatively impact academic quality and performance. Objective: to evaluate the quality of sleep in university students from public and private institutions, users of ESDs. Methods: The study will be an observational cross-sectional, previously approved by the Human Research Ethics Committee of the State University of Minas Gerais - Divinópolis Unit, under protocol number 6.796.312/2024, in which the sample will be recruited through social networks and in person. Participants will answer the questionnaires through Google Forms, after being transcribed. The following questionnaires will be used: sociodemographic form, Pittsburgh Sleep Quality Index (PSQI), Fargeström test and Leicester questionnaire (LCQ), respectively assessing sleep quality and presence of sleep disorders, level of chemical dependency and nocturnal cough. Discussion: The use of subjective tools, such as a questionnaire to assess sleep in this population, is justified by its low cost and easy application. Recognizing these changes in the sleep of university students is important, as they can negatively impact academic quality and performance. In addition, the study may contribute to awareness campaigns and the development of public health policies, expanding data on the subject and facilitating access so that the number of preventive measures and campaigns for this population can increase.
Background: Breast cancer, the second most common oncological disease in Brazil, is estimated to have approximately 73,000 new cases in the Brazilian female population in the 2023-2025 triennium. Considering the treatments offered, physiotherapy emerges as a tool in the treatment of various conditions, such as musculoskeletal disorders and pain resulting from traditional antineoplastic therapies, with resources such as laser therapy available for this management. Objective: To establish a physiotherapeutic intervention protocol, based on scientific evidence, for women with breast cancer. Method: This is a physiotherapeutic protocol that is part of a randomized, placebo-controlled, double-blind clinical trial, approved by the Research Ethics Committee of SCS/UFPR (CAAE: 71033323.9.0000.0102), to evaluate the effects of photobiomodulation on breast cancer. The study will recruit 60 women with breast cancer, aged between 21 and 60 years, who are undergoing active antineoplastic treatment. The developed protocol consists of four physiotherapeutic techniques: cervical pompage associated with breathing exercises, kinesiotherapy, and clay therapy. Clay therapy consisted of applying white clay to the entire face of the participant, lasting approximately 15 minutes. Kinesiotherapy included range of motion exercises of rotation, inclination, flexion, and extension of the cervical spine, in a prescription of 2 sets of 10 repetitions, in addition to static stretching of the upper limbs, in 2 sets of 60 seconds. The pompage and breathing exercises combined cervical rotation with pursed-lip breathing, lateral cervical inclination with diaphragmatic breathing, and the pranayama surya bedhana technique with the pompage of the pectoralis major. Conclusion: The proposed protocol is expected to be an efficient resource for managing the well-being of study participants during Modified Intravascular Laser Blood Irradiation applications, potentially providing comfort associated with the therapeutic application of the laser.
